Abstract: TH-PO243
Middle-Molecular Weight Toxin Removal: Asymmetric Cellulose Triacetate vs. Helicoidal Polysulfone during Online Hemodiafiltration (CHORALS Study)
Session Information
- Hemodialysis, Hemodiafiltration, and Frequent Dialysis
October 24, 2024 | Location: Exhibit Hall, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Dialysis
- 801 Dialysis: Hemodialysis and Frequent Dialysis
Authors
- Ferrarini, Marco, Universita degli Studi di Modena e Reggio Emilia, Modena, Italy
- Morisi, Niccolò, Universita degli Studi di Modena e Reggio Emilia, Modena, Italy
- Giovanella, Silvia, Universita degli Studi di Modena e Reggio Emilia, Modena, Italy
- Ligabue, Giulia, Universita degli Studi di Modena e Reggio Emilia, Modena, Italy
- Alfano, Gaetano, Universita degli Studi di Modena e Reggio Emilia, Modena, Italy
- Troise, Dario, Universita degli Studi di Foggia, Foggia, Italy
- Stallone, Giovanni, Universita degli Studi di Foggia, Foggia, Italy
- Donati, Gabriele, Universita degli Studi di Modena e Reggio Emilia, Modena, Italy
Background
Middle-molecular weight toxins (MMT) are involved in cardiovascular and neurological morbidity and in a high risk of mortality of HD patients. In this study we evaluate the efficiency of Asymmetric Cellulose Triacetate (ATA) vs Helicoidal Polysulfone (PS) in MMT removal during online hemodiafiltration (OLHDF).
Methods
Twenty anuric HD patients who needed OLHDF were selected. Ten patients underwent PS OLHDF as gold standard treatment, 10 patients underwent ATA OLHDF when a history of hypersensitivity was ascertained. B2 Microglobulin (B2M) and K light chain (Lk) were assayed hourly on blood and on spent dialysate. Total clearance (Ktot) and Sieving coefficient (S) were firstly evaluated separately through time for each filter with ANOVA. To compare Ktot and S between filters, we performed t-test on data from each hour separately and 2-way ANOVA on the whole series.
Results
No significant efficiency variation over time was observed in the ATA filter. The PS filter showed significant variation of B2M Ktot and S due to rising efficiency at the first hour (Ktot p=0.001, S p=0.001) but not in Lk. Considering the whole series, Ktot and S of B2M were significantly higher for PS (p<0.0001). Comparing filters, PS showed significantly higher Ktot and S after 1 hour of treatment for both B2M (Ktot p=0.001, S p=0.001) and Lk (Ktot p=0.022, S p=0.02) and after 2 hours of treatment for B2M only (Ktot p=0.015, S p=0.008). No significant Ktot and S variation was observed between filters at other time points (Figure 1).
Conclusion
Globally, removal performance of MMT is similar for both filters tested. Given the features of ATA membrane, which is predicted to be more biocompatible for hypersensitivity prone patients, slightly lower performances are observed in the first half of treatment. As a consequence, the choice of ATA membrane should be considered suitable for MMT removal in patients with hypersensitivity.
p<0.05 (**); p<0.01 (***)